September 2025 newsletter
AI Summary
Aetna's September 2025 newsletter announces multiple upcoming changes including new claim edits starting December 1, 2025, National Precertification List changes effective January 1, 2026, and commercial drug list updates also effective January 1, 2026. The newsletter emphasizes the importance of keeping provider profile information updated to avoid directory removal.
Action Required
By November 30, 2025: Billing team must review new claim edits on Availity portal for the Claim and Code Review Program starting December 1, 2025. Before January 1, 2026: Review National Precertification List changes and commercial drug list updates. Immediately: Verify and update provider profile information in Availity's Provider Data Management tool to avoid removal from provider directory.
Plan Types
Commercial, Medicare Advantage, Traditional Medicare
Specialties
all-specialties